Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Mandatory Testing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,351 records · Page 75Linked to original sources
PubMed1995

[Conduction anesthesia on an outpatient basis].

Regional anaesthesia in the setting of pre-hospital trauma care implies adverse conditions. Therefore some practical advices may be useful; avoid spinal or epidural anaesthesia, prefer safer lidocaine. Aspiration test, test dose and slow injection are mandatory; so is a large experience in regional anaesthesia. Main usable blocks are: brachial plexus block (axillary or interscalenic approach), radial, medial and ulnar nerve blocks, intercostal and interpleural nerve blocks, sciatic and femoral nerve blocks, superior laryngeal nerve block. Using a nerve stimulator is strongly advised in most cases.

Ambulatory Care↗
PubMed2006

Models of preconception care implementation in selected countries.

Globally, maternal and child health faces diverse challenges depending on the status of the development of the country. Some countries have introduced or explored preconception care for various reasons. Falling birth rates and increasing knowledge about risk factors for adverse pregnancy outcomes led to the introduction of preconception care in Hong Kong in 1998, and South Korea in 2004. In Hong Kong, comprehensive preconception care including laboratory tests are provided to over 4000 women each year at a cost of $75 per person. In Korea, about 60% of the women served have known medical risk history, and the challenge is to expand the program capacity to all women who plan pregnancy, and conducting social marketing. Belgium has established an ad hoc-committee to develop a comprehensive social marketing and professional training strategy for pilot testing preconception care models in the French speaking part of Belgium, an area that represents 5 million people and 50,000 births per year using prenatal care and pediatric clinics, gynecological departments, and the genetic centers. In China, Guangxi province piloted preconceptional HIV testing and counseling among couples who sought the then mandatory premarital medical examination as a component of the three-pronged approach to reduce mother to child transmission of HIV. HIV testing rates among couples increased from 38% to 62% over one year period. In October 2003, China changed the legal requirement of premarital medical examination from mandatory to "voluntary." This change was interpreted by most women that the premarital health examination was "unnecessary" and overall premarital health examination rates dropped. Social marketing efforts piloted in 2004 indicated that 95% of women were willing to pay up to RMB 100 (US$12) for preconception health care services. These case studies illustrate programmatic feasibility of preconception care services to address maternal and child health and other public health challenges in developed and emerging economies.

Belgium↗
PubMedDate not supplied

In vitro susceptibilities to topical antibiotics of bacteria isolated from the surface of clinically symptomatic eyes.

BACKGROUND: The permanent change of resistance patterns of bacteria causing ocular infections makes repeat susceptibility testings against the most recent clinical isolates mandatory. The aim of the present study was to assess the in vitro susceptibility of ocular bacterial isolates of clinically symptomatic eyes admitted to the outpatient clinic of the eye department of a large central hospital to commonly used topical antibiotics. METHODS: Ocular isolates (n = 454) were tested for their susceptibility to ofloxacin, ciprofloxacin, norfloxacin, gentamicin, tobramycin, meomycin, bacitracin, erythromycin, tetracycline and chloramphenicol. RESULTS: All three tested fluoroquinolones were found to be very effective against gram-negative organisms but demonstrated some weakness against certain strains of gram-positive germs, in particular coagulase-negative staphylococci and Streptococcus viridans. These germs, however, were very susceptible to bacitracin and chloramphenicol. The relative overall in vitro efficacy was (in decreasing order): chloramphenicol, ciprofloxacin, ofloxacin, norfloxacin, bacitracin, tetracycline, neomycin, erythromycin, tobramycin and gentamicin. CONCLUSION: Chloramphenicol had the highest overall in vitro efficacy, but has potential lethal side effects. The fluoroquinolones were highly effective, especially being superior to the aminoglycosides tested, but no single antibiotic provided 100% coverage against all of the bacterial isolates that were tested.

Aminoglycosides↗
PubMed1997

Sensitization to Blomia kulagini in a general population of a subtropical region of Spain (Canary Islands).

The Blomia genus has been described as allergenic in man. The present study aimed to assess the prevalence of B. kulagini sensitization in a large population of allergic subjects without occupational exposure in a subtropical region (Canary Islands, Spain). Secondarily, a new standardized B. kulagini extract was evaluated. The study population comprised 207 patients. RAST for B. kulagini was positive in 76.2% of patients, and 47 of them were selected for the biologic standardization. When the prick test was performed with the nonstandardized extracts, results were positive in 76.6%, whereas when the test was repeated with the standardized extract, sensitivity rose to 95.7%. The conjunctival provocation test was positive in 78.3% of 46 evaluated patients. The bronchial provocation test was positive in 18 sensitized patients and negative in five controls. In conclusion, B. kulagini is an important cause of sensitization among the occupationally unexposed population of the studied area and should be included in allergy diagnostic tests. For reliable prick tests, the use of standardized extracts is mandatory.

Adolescent↗
PubMedDate not supplied

[Cognitive development of children and adolescents after correction of transposition of great vessels].

BACKGROUND: To study the effect of transposition of the great arteries on later cognitive functioning. PATIENTS: Twentyeight children and adolescents underwent psychometric testing 3.5 to 13.7 years following operation. METHODS: A battery of intelligence, attention and visual memory tasks as well as the Draw-a-Man-Test were administered. Parents completed standardized questionnaires on developmental milestones. RESULTS: Both, mean verbal (93 +/- 15) and performance IQs (97 +/- 21) were normal. The length of interval between operation and psychologic test but not age at repair was a significant predictor of intelligence quotient. Half of the children (9/18) showed attention deficits, 7/11 (64%) were identified as suspect of brain dysfunction. Performance on the Draw-a-Man-Test disclosed 12 (43%) as slightly mentally retarded. CONCLUSIONS: (1) Cognitive functions in children with TGA are more impaired than suggested by the results of intelligence tests. (2) Psychological and neurologic follow-up should be mandatory from early on. (3) Previous studies have overestimated children's intelligence due to unrecognized changes of test norms.

Adolescent↗
PubMed1992

Age as a bona fide occupational qualification for firefighting. A review on the importance of measuring aerobic power.

Recent federal and judicial initiatives have led to controversy over the justification of mandatory retirement policies applied to public safety occupations. The Equal Employment Opportunity Commission has been mandated to study this issue, and a critical element of that study will be to determine the types of tests to be employed as substitutes for a mandatory retirement age. In this review, a rationale is presented for the measurement of aerobic power (VO2max) as a predictor of the physical performance capability of firefighters. We conclude that task simulations rarely replicate the environmental conditions present at structural fires that stress the cardiorespiratory capability of firefighters. VO2max is an important predictor of performance effectiveness of firefighters to be used in conjunction with task-specific testing.

Age Factors↗
PubMed1980

Aging and mastication: changes in performance and in the swallowing threshold with natural dentition.

Few comprehensive studies of oral function have been conducted on adult populations. A "Longitudinal and Cross-Sectional Study of Oral Health in Healthy Veterans" was activated at the VA Outpatient Clinic in Boston in 1969; it included general oral and dental examinations as well as tests of masticatory performance and the swallowing threshold. The current investigation involved 863 subjects from the "Dental Study" who had either their natural teeth or a fixed replacement for missing teeth. Masticatory performance as measured by the subject's ability to reduce a test portion of cut carrot by a mandatory number of chewing stroked remained constant for persons with complete or partially compromised natural dentition. Swallowing threshold performance as measured by the particle size acceptable for swallowing remained constant for persons with complete dentition. Tooth loss significantly decreased the swallowing threshold performance and increased the particle size which the subject was willing to swallow. Older subjects increased the number of chewing strokes and the time required for this test, an observation not related to performance as measured by final particle size. Only with compromised dentition, however, did this increased effort result in increased performance.

Adult↗
PubMed1994

Automatic selection of tidal volume, respiratory frequency and minute ventilation in intubated ICU patients as start up procedure for closed-loop controlled ventilation.

OBJECTIVE: Before a patient can be connected to a mechanical ventilator, the controls of the apparatus need to be set up appropriately. Today, this is done by the intensive care professional. With the advent of closed loop controlled mechanical ventilation, methods will be needed to select appropriate start up settings automatically. The objective of our study was to test such a computerized method which could eventually be used as a start-up procedure (first 5-10 minutes of ventilation) for closed-loop controlled ventilation. DESIGN: Prospective Study. SETTINGS: ICU's in two adult and one children's hospital. PATIENTS: 25 critically ill adult patients (age > or = 15 y) and 17 critically ill children selected at random were studied. INTERVENTIONS: To stimulate 'initial connection', the patients were disconnected from their ventilator and transiently connected to a modified Hamilton AMADEUS ventilator for maximally one minute. During that time they were ventilated with a fixed and standardized breath pattern (Test Breaths) based on pressure controlled synchronized intermittent mandatory ventilation (PCSIMV). MEASUREMENTS AND MAIN RESULTS: Measurements of airway flow, airway pressure and instantaneous CO2 concentration using a mainstream CO2 analyzer were made at the mouth during application of the Test-Breaths. Test-Breaths were analyzed in terms of tidal volume, expiratory time constant and series dead space. Using this data an initial ventilation pattern consisting of respiratory frequency and tidal volume was calculated. This ventilation pattern was compared to the one measured prior to the onset of the study using a two-tailed paired t-test. Additionally, it was compared to a conventional method for setting up ventilators. The computer-proposed ventilation pattern did not differ significantly from the actual pattern (p > 0.05), while the conventional method did. However the scatter was large and in 6 cases deviations in the minute ventilation of more than 50% were observed. CONCLUSIONS: The analysis of standardized Test Breaths allows automatic determination of an initial ventilation pattern for intubated ICU patients. While this pattern does not seem to be superior to the one chosen by the conventional method, it is derived fully automatically and without need for manual patient data entry such as weight or height. This makes the method potentially useful as a start up procedure for closed-loop controlled ventilation.

Adolescent↗
PubMed1989

Clinical management of the fetus with markedly diminished umbilical artery end-diastolic flow.

This study was conducted to evaluate prospectively a management protocol for fetuses with a markedly abnormal umbilical artery velocity waveform. The study population consisted of fetuses whose systolic/diastolic ratio was greater than 2 SD above the mean for gestational age. The matched control population consisted of fetuses with similar gestational ages, indications for testing, and estimated fetal weights with normal systolic/diastolic ratios. Abnormal Doppler results were used only to determine the frequency of fetal testing. Biophysical profile testing was performed semiweekly on all patients. Patients with absent or reversed end-diastolic flow were admitted for daily testing. The following criteria were used as indications for delivery: (1) worsening maternal condition, (2) oligohydramnios, (3) intrauterine growth retardation with lung maturity, and (4) biophysical profile score less than or equal to 4. Fifty-one patients (7%) had abnormal Doppler blood flow velocity studies. When the study population was compared with the control population at the time of delivery, there were no differences in umbilical artery pH, Apgar score, or incidence of intrauterine growth retardation. However, study patients were delivered at a significantly lower gestational age and lower birth weight and experienced a higher likelihood of neonatal intensive care unit admission. When study patients with documented end-diastolic flow were compared with study patients with no end-diastolic flow, there were no differences in umbilical artery pH, Apgar score, or incidence of intrauterine growth retardation. However, fetuses with no end-diastolic flow had a significantly shorter test-to-delivery interval, lower gestational age, lower birth weight, and more neonatal intensive care unit admissions. There were no perinatal deaths among the study patients. The range of systolic/diastolic ratios for the five patients who failed to follow our protocol for intensive maternal-fetal surveillance was 4.3 to infinity; all experienced fetal death within 18 days. These results suggest that immediate delivery of the fetus with diminished end-diastolic flow may not be mandatory. The combined use of fetal biophysical testing and commonly used criteria for delivery results in acceptable fetal outcome and prolongation of gestational age.

Blood Flow Velocity↗
PubMed2003

Classification and diagnosis of prostatitis: a gold standard?

The National Institutes of Health Classification System for prostatitis has now been accepted by the North American and International urology community. This categorization system consists of category I (acute bacterial prostatitis), category II (chronic bacterial prostatitis), category III (chronic prostatitis/chronic pelvic pain syndrome - CP/CPPS) and category IV asymptomatic inflammatory prostatitis. The evaluation of a patient with category I and category II bacterial prostatitis consists of history and physical examination and urine culture for lower urinary tract localization cultures, respectively. The clinical tests for the evaluation of CP/CPPS can be classified as mandatory, recommended and optional. Mandatory evaluations include history and physical examination, urinalysis and urine culture. Recommended evaluations include lower urinary tract localization tests, symptom index, flow rate, residual urine determination and urine cytology. Optional evaluations include semen analysis and culture, urethral swab, urodynamics, cystoscopy, imaging, and prostate specific antigen determination. The physician must individualize a rational diagnostic strategy for each patient. There is no 'gold standard' for the diagnosis and evaluation of patients presenting with prostatitis.

Bacterial Infections↗
PubMed1997

Survivors of out-of-hospital cardiac arrest with apparently normal heart. Need for definition and standardized clinical evaluation. Consensus Statement of the Joint Steering Committees of the Unexplained Cardiac Arrest Registry of Europe and of the Idiopathic Ventricular Fibrillation Registry of the United States.

BACKGROUND: A wide variety of structural abnormalities are associated with the vast majority of cardiac arrests. However, there is no evidence of structural heart disease in approximately 5% of victims of sudden death, indicating that cardiac arrest in the absence of organic heart disease is more common than previously recognized. The risk of recurrence and the acute and long-term response to therapy are important but unanswered questions. Data from the small series reported so far are of limited value because of the lack of uniform criteria to define and diagnose idiopathic ventricular fibrillation (IVF). METHODS AND RESULTS: This report originates from a Consensus Conference convened by the Steering Committees of the European (UCARE) and North American (IVF-US) Registries on IVF under the auspices of the Working Group on Arrhythmias of the European Society of Cardiology. Its objective is to provide a unified definition of IVF and to outline the investigations necessary to make this diagnosis. Minimal diagnostic tests for the exclusion of an underlying structural heart disease include non-invasive (blood biochemistry, physical examination and clinical history, ECG, exercise stress test, 24-hour Holter recording, and echocardiogram) and invasive (coronary angiography, right and left ventricular cineangiography, and electrophysiological study) examinations. Programmed electrical stimulation, ventricular biopsy, and ergonovine test during coronary angiography are recommended but not mandatory. CONCLUSIONS: It is recognized that despite careful evaluation, conditions such as focal cardiomyopathy, myocarditis, or fibrosis and transient electrolyte abnormalities may remain silent. Therefore, patients should undergo careful follow-up, with noninvasive tests repeated every year. The existence of a unified terminology will allow meaningful comparison of data collected by different investigators and will thus contribute to a better understanding of IVF.

Diagnosis, Differential↗
PubMed1999

Prevalence of alcohol problems among pediatric residents.

OBJECTIVE: To measure the prevalence of alcohol-related problems among pediatric trainees. METHODS: An alcoholism screening test was administered anonymously to participants at a mandatory substance abuse education and prevention program. SETTING: A large urban pediatric residency training program. SUBJECTS: One hundred fifteen pediatric residents attended the program during 3 consecutive years (1996-1998). Eighty-five (74%) screening tests were returned and 81 (70%) were analyzed MAIN OUTCOME MEASURE: The 25-item Michigan Alcoholism Screening Test (MAST). Differential MAST cutpoints have been established to "suggest" or "indicate" a lifetime diagnosis of alcoholism. RESULTS: Twelve residents (15%) had scores suggestive and 6 (7%) indicative of alcoholism. Twenty-eight (35%) admitted to having alcohol-associated amnesia (blackouts), 13 (16%) to "feeling bad" about their drinking, 9 (11%) to drinking before noon, 6 (7%) to getting into fights when drunk, and 2 (2%) to alcohol-related marital problems. However, only 1 (1%) had gone to anyone for help and none admitted to alcohol-related problems at work. CONCLUSIONS: These screening data suggest that alcohol abuse and related problems exist among pediatric trainees at troubling rates. While more than one third of the trainees had experienced a serious consequence from heavy drinking, only 1 had gone for help and problems were not apparent at work. Greater emphasis should be placed on alcohol prevention and early intervention programs as a routine part of pediatric training.

Adult↗
PubMed1998

Quality management in the medical laboratory: a comparison of draft standards.

Clinical laboratories used to rely almost completely on functional tests to monitor and assess their performance. This is known as internal quality control (IQC). A supporting approach is the interlaboratory comparison. In many countries and other disciplines this is known as proficiency testing, whereas, in Europe, the procedure is better known as external quality assessment taken care of by different schemes (EQAS). Probably all laboratories participate in some kind of EQAS and in some countries it is mandatory. It has gradually become apparent that functional tests are not sufficient to achieve, assure and develop quality in medical laboratories. Therefore other means must be sought. The principles laid down in the ISO 9000 series and the total quality concept has become interesting; in particular, accreditation. Accreditation of laboratories has been available for many years and in fact is routine in some specialities e.g. food, water laboratories and in some countries also for laboratories in the veterinary field. The present paper describes some features of the available and planned ISO standards that deal with accreditation of laboratories and particularly those adopted for the medical laboratories.

Accreditation↗
PubMed2000

Selective omission of the donor cross-match before renal transplantation: efficacy, safety and effects on cold storage time.

BACKGROUND: A donor lymphocyte cross-match (XM) test performed before renal transplantation is considered mandatory but may delay the transplant and increase the cold storage time. With careful documentation of sensitizing events and with knowledge of previous antibody screening results, it is often possible to predict the XM result for a given donor HLA mismatch. In this study, a policy was adopted of omitting the pretransplant XM in patients in whom a negative result was predicted with absolute confidence. METHODS: Recipients were selected for cadaveric donor kidney transplantation using a computer algorithm based on HLA match, sensitization status, time on the waiting list and donor and recipient age. The immediate pretransplant cross-match test was omitted in non-sensitized recipients and in sensitized recipients where antibody specificities were precisely defined and not against donor HLA. RESULTS: From October 1997 to May 1999, 53 of 96 (55%) consecutive cadaveric kidney donor transplants were performed without a pretransplant XM. In all cases, a negative donor HLA-specific antibody XM was confirmed after transplantation. Omission of the pre-transplant XM was associated with a significant reduction in cold ischemic time (15.0 hr vs. 18.2 hr, P=0.01) and a reduced incidence of delayed graft function (13% vs. 33%, P=0.03). However, there was no difference in transplant outcome at 1 year. CONCLUSION: Rigorous attention to priming events together with careful antibody screening allows the pre-transplant XM test to be safely omitted in approximately half the patients awaiting renal transplantation. This policy allows a modest reduction in cold ischemia time, but it remains to be seen whether this is of clinical benefit.

Adult↗
PubMed1996

Severe Legionnaire's disease requiring intensive care treatment.

BACKGROUND: Legionnaire's disease is well known as severe pneumonia requiring intensive care treatment in many cases. In this study the clinical course is described of patients admitted to the medical ICU of the University Hospital of Rotterdam for respiratory distress due to Legionnaire's disease. METHODS: From the register of admissions to the medical ICU all patients suffering from Legionnaire's disease were identified. All data on clinical signs and symptoms present on admission were collected. The circumstances in which the infections were contracted were sought, as well as the tests establishing the diagnosis. The occurrence of various organ failures and complications were noted, as were the causes of death on the ICU. RESULTS: From 1978 till 1995 the diagnosis of Legionella pneumonia was made in 17 patients admitted to the ICU: in 13 patients a community-acquired infection was established. As in 12 patients Legionnaire's disease was diagnosed on serological tests, it took several weeks before the diagnosis could be established in these patients. In all patients the circumstances predisposing to Legionnaire's disease were noted. Respiratory distress was present in all patients, ventilatory support was required in 14. Apart from this, both profound shock and renal failure were commonly encountered. As complications jaundice, rhabdomyolysis and polyneuropathy were frequently noted. Three patients died: 2 due to irreversible shock and 1 due to hospital-acquired sepsis. CONCLUSION: Legionnaire's disease can develop into life-threatening pneumonia requiring intensive care treatment in previously healthy subjects. As the clinical features are aspecific, careful search for predisposing circumstances such as recent travel or use of a contaminated water-supply is mandatory. As the diagnosis required positive serological tests in most patients, a considerable delay in diagnosis was noted. Despite the frequent occurrence of multiple organ failure, a favourable outcome can be anticipated in most cases.

Adult↗
PubMed2006

[Evaluation of immunochromatographic test kits for food allergens using processed food models].

It has been mandatory to label five allergenic substances (AS; egg, milk, wheat, buckwheat and peanut) in all processed foods, since April 2002 in Japan. Two kinds of ELISA kits have been provided as screening test kits for the Japanese official method. The kits have many advantages but some disadvantages, i.e., the kits are not necessarily suitable for daily monitoring in food manufacturing plants, because they require various analytical equipments and the use of complicated procedures. To overcome these drawbacks, we have developed other diagnostic kits based on immunochromatography that should enable more rapid and simple screening for food allergens. Then we examined the performance of these immunochromatographic test kits (IC kits) in terms of sensitivity, repeatability and cross-reactivity to AS proteins in 11 kinds of food models with various heating conditions and physical properties. We also examined processed food models including AS protein of constant concentration, using the IC kits and ELISA kits, and compared the results. The IC kits detected AS proteins at 5 microg/g in the extracts from processed food models, and provided highly reproducible results. Cross-reactivity among the AS proteins was not observed. The results obtained using the IC kits showed performance equivalent to that of the ELISA kits we examined in unheating processed food models including AS proteins of constant concentration. The IC kits should be more suitable for daily monitoring in food manufacturing plants.

Allergens↗
PubMed2006

Why disclosure of genetic tests for health insurance should be voluntary.

Whether the disclosure of genetic (and non-genetic) information should be mandatory or voluntary is of concern. At present there are two opposing camps--the insurance industry argues for mandatory disclosure to avoid problems of adverse selection, and genetic interest groups argue for voluntary disclosure, fearing discrimination and public reluctance to have tests, thus missing out on any benefits from subsequent interventions. Policy has to balance these sides of the debate, as reducing adverse selection and encouraging maximum take-up of tests are both important for public health. We outline why voluntary disclosure is the optimal policy as it creates an incentive for people both to undergo testing and to disclose their result thus reducing the potential for adverse section.

Genetic Testing↗